A Hernia – What Next?

Stock Hernia Pain

I had my bladder removed in 2017 and I have to say it was the best thing I could have done. Not only has it saved my life (nearly three years and no evidence of disease now), but it also saved me from constant infections, feeling poorly and god only knows how many night trips to the toilet. 

It’s all been pretty much easy sailing since around month eight after my cystoscopy... until a few months ago.

The lumps and bumps of having a stoma.

Don't judge me, but I have put on quite a bit of weight since lockdown. Damn those salted caramel magnum bars (thanks Viv!) and let's not forget teaching the grandchildren to bake cookies, brownies and so on. 

Why do I mention this? Well, other than trying to shame myself into not eating ever again, weight is often a factor in getting a hernia – stay with me as I set the scene. Picture this... I am lying on the sofa, with a bloated upper abdomen, feeling very tender and bruised with a pain in my left side, and then I go to sit up. As I sit up, I can see something, and it feels odd.

It looks like a little lump under the skin, so I did what everyone else would do... I poked and prodded it, not content with that, I also got my hubby and friends to prod and poke at it too. And then googled the hell out of "lumps in upper abdomen", "hernias" and "small cell bladder cancer metastasis" …you get the picture.

Time went on and I would occasionally have a little feel for this hernia but is soon got worse.

A couple of weeks ago I was having a really bad day pain-wise. My erythromelalgia was flaring up, my poor tummy was in knots. I wondered if I had trapped wind. The skin on my upper abdomen was hot, swollen and terribly tender to touch. My bowels had not been playing nicely, I could feel the gurgling as it went through my digestive system. We put this down to the CREON (a digestive medication) that I take when I eat. 

My hubby, Tim, decided that enough was enough and I was to speak to someone the next working day. I didn't want to. Let me explain. I hate going to see my doctors, I very rarely go. The reason? With all my complicated medical issues going on I never seem to get any help. There is rarely empathy nor useful advice other than, "take paracetamol".

Thank goodness for Stoma Care Nurses. I spoke to a lovely nurse on the phone who said that she could see me the following day. 

I met Shelley in the foyer of the hospital, and we went to a room so she could examine me. I explained everything that had been going on, told her to feel my tummy whilst I was standing up, as you can feel a little lump there or sometimes you can feel something the size of a Mars Bar. It was a hernia.

Shelly recommended I get in touch with my doctor and let them know about the diagnosis. I did, basically he told me not to worry that hernias “aren't dangerous” and often can be left alone! 

Eek... this is why I don't go to the doctors if I don't have to. Luckily, I am an advocate for my own health.

Hernias occur when an organ or tissue pushes through a weak spot in the abdominal wall.

There are six types:

  • An incisional hernia - around a previous surgery site
  • An umbilical hernia - around the navel area
  • An indirect inguinal hernia - in the groin area
  • A direct inguinal hernia – also in the groin area
  • A femoral hernia - just below the groin
  • An epigastric hernia - the upper abdomen 

I have an incisional hernia where the keyhole surgery for my bladder removal operation took place.

What to watch out for if you are concerned about parastomal hernias.

Hernias tend to present themselves as a lump or bulge in the area of weakness. It can make you feel uncomfortable and, in my case where it’s in the upper abdomen, it’s made me feel full and bloated. The whole of the upper area feels tender and bruised to the touch.

Diagnosis

Your doctor or Stoma Care Nurse will be able to diagnose your hernia by feeling and touching the area in question, in some cases they will also arrange for an ultrasound. The ultrasound will be will able to show a bigger picture of what’s happening inside your body. An ultimate diagnosis should be done via CT scan, but access to this can be challenging.

Treatment 

Hernias do not usually repair themselves and often require surgery to repair the weakened site. Hernias can grow a lot bigger and cause complications. The treatment that you receive depends on the type of hernia you have. You may decide to take the 'wait and see’ approach. If your hernia isn't causing any pain, is small and unproblematic then perhaps you would prefer this route.

There are two types of surgery for hernias: laparoscopic surgery (also known as keyhole surgery) or an open repair, which is more invasive than the keyhole and would require more healing time. 

In both cases surgical mesh is used to provide support and strength for the area involved.

Prevention 

In order to help yourself, you may have to make lifestyle changes. For me, I desperately need to lose weight and somehow strengthen my abdomen muscles, however there is a risk that I could disturb the hernia and cause myself damage (haha, no exercise for me then, pass the cake!). 

You will have to be careful when lifting items - get someone else to carry the shopping bags if you can, and also take care with bending over as this can aggravate the damaged site. 

Try not to overuse your muscles, i.e. repetitive movements although things like coughing and sneezing cannot be helped. I think mine has come about due to the horrendous cough I had which lasted six months. One thing that might help if you are going to cough or sneeze, is to support the muscle area by using your hand with a towel. 

On a serious note, we all know that being overweight and unfit isn't good for us, nor our hernias, so at some point you may have to address these issues. For the moment though, with all the COVID-19 issues, I am taking the ‘wait and see' approach. For information on parastomal hernias and how to prevent them please visit our sister company, CliniMed.

by Anita Brown

Anita Brown

About the author

Hi I’m Anita Brown. Diagnosed with terminal small cell bladder cancer in April 2016. I've had palliative chemo and radiotherapy, and a radical cystectomy and urostomy in August 2017.

I've had problems with my bladder all my life, from incontinence, to kidney and bladder stones, and now cancer. I would like to share some of my experiences - follow me on Twitter.

Recent Comments

  • Patricia Millar

    I am a wheelchair user, I have a urostomy, last two years been in and out of hospital with urinery tract infections, I also had parastomal hernia until last year I was taken into hospital, had hernia fixed but also had bowel removed, now have illiostomy as well, sewn up butt, surgery was last December, still can’t eat things I like, but I’m still here which is a bonus

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